Applicant Information

Name:

Date of birth:

Pilot Cert No:

Phone:

Current address:

City:

State:

ZIP Code:

Total Flight Hours:

Balloon PIC Hours:

Pilot Certificate Issued:

for flight instructor – initial designation

ÿ Current BFA Member BFA Member No. _____________________ Expiration Date ______________________

ÿ FAA Commercial Pilot Certificate

ÿ Minimum 75 hours PIC OR 50 flights

One of the following:

ÿ Passing grade on Fundamentals of Instruction Knowledge Exam (attach copy of test results)

ÿ Valid Teaching Certificate issued by a State Department of Education

ÿ FAA Certificated Flight Instructor (category/class immaterial) OR FAA Designated Pilot Examiner for LTA, Free Balloon

for master flight instructor – initial designation

ÿ Current BFA Member BFA Member No. _____________________ Expiration Date ______________________

ÿ Completed 24 months as BFA Flight Instructor

ÿ Minimum 150 hours OR 100 flights

ÿ Attended a BFA sanctioned Safety Seminar with last 24 months. Date______________ Location:______________________

ÿ Successful trained a minimum of five (5) student pilots to completion (attach copies of logbook endorsements)

Flight instructor/master flight instructor - renewal

For renewal, the applicant must have completed any two of the following:

ÿ Attended a BFA sanctioned Safety Seminar with last 24 months. Date______________ Location:______________________

ÿ Attended a BFA Flight Instructor Refresher Clinic, or a Certificated Flight Instructor (CFI) Recurrency Seminar which meets FAA requirements for recertification of a CFI (category/class immaterial), or, in the case of an FAA Designated Pilot Examiner, has completed the required biennial training.

ÿ Successful trained a minimum of five (5) student pilots to completion (attach copies of logbook endorsements)

Instructions

Mail completed application with substantiating documentation and appropriate fee ($10.00 for Flight instructor, $20.00 for Master Flight Instructor) to:

Balloon Federation of America

P.O. Box 400

Indianola, Iowa 50125

Signature

I certify that the information contained herein is true and complete to the best of my knowledge.

Signature of Applicant:

Date:

for office use only

ÿ Fee as appropriate $_______________ received

ÿ Documentation complete

ÿ Forwarded to Program Manager

ÿ Designation card issued ________________________